Olive Grove 2010 Registration Form 
           (copy and paste form as needed)

 

One Week $275 (before April 1:  $255*)    Two weeks $410 (before April 1: $390*)

     * Early fees must be paid in full no later than April 1, 2010.

Week 1 (June 19 - 26) ____ Week 2 (June 26 - July 3) ____

Week 1 & 2 (June 19 – July 3) ____

Child’s Information:

Passport Country: _________________________ Passport Number: _____________________

Age: ________ Birthdate: _______day_______month_________year

Gender: ______
Grade entering autumn 2010: _______
Name/type of school: ___________________________________________________________
Religious background: __________________________________________________________

Parents’ Information:
Father’s name: _____________________________________________________
Nationality: ____________________________________________________

Religious background :___________________________________________

Mother’s name: _____________________________________________________
Nationality:_____________________________________________________

Religious background: ___________________________________________

Contact Information:

Telephone & E-mail:

Home: ___________________________

Mother’s Cell: __________________________ Father’s Cell: ________________________

Mother’s work: _________________________ Father’s work: _______________________
Child’s Cell: ___________________________ (to contact child while in transit, if need be)

Emergency Contact (name & number): _________________________________________

Father’s e-mail:__________________________________________
            Mother’s email: __________________________________________

Child’s e-mail: ___________________________________________

Current mailing address: ____________________________________________________

                                        ____________________________________________________

Additional information about your child:

Please list information you would like to share about your child that may affect his/her experience at OG and that may help us to serve your child better; for example, loss of a family member, recent changes in home life, new to the country, school changes, learning disabilities, etc.:

 

Statement of agreement:

We understand that Olive Grove operates under the auspices of the St. Paul Cultural Center. While lessons and challenges from the Bible constitute a vital part of the daily program, utmost respect for children and their families is a rule. No child, under any circumstances, will be pressured into or prevented from adopting or abandoning certain religious beliefs. Furthermore, the leaders of Olive Grove will do their best to inform parents of any significant spiritual decisions their children make or developments they undergo while attending Olive Grove.

We understand that Olive Grove has an established program and set activities in which each child is expected to participate. Respect for leadership and other participants are necessary for a positive camp environment. Olive Grove leadership reserves the right to send a child home at the parent’s expense, if he or she is not willing to adhere to the Olive Grove program. Also, children are expected to stay onsite and not leave with parents during the camp program unless the parents choose to withdraw their child from the program.

We also agree that all payments for Olive Grove, including registration deposit, registration, transportation transfer fees, fees for certain electives, and any additional meal fees, will be paid on time. We understand that late payments will be due if payments are not given by due dates, and we agree to pay those fees.

We understand that Olive Grove will not be liable or responsible for our child’s personal items that are lost or damaged. Olive Grove will also not be financially accountable for medical expenses accrued by your child, nor will be liable for any medical expenses which happen during transportation to and from Olive Grove, or during Olive Grove. Olive Grove expects all campers to have adequate medical insurance coverage through their parents. We affirm that we have proper medical insurance for our child.

Father’s Name (print clearly): ________________________________________ 

       Signature: _____________________________________

       Date of agreement: ______________________________

Mother’s Name (print clearly): _______________________________________ 

       Signature:  _____________________________________

       Date of agreement: ______________________________